Neurocritical Care

, Volume 17, Issue 2, pp 281–292 | Cite as

Effects of High-frequency Oscillatory Ventilation on Systemic and Cerebral Hemodynamics and Tissue Oxygenation: An Experimental Study in Pigs

  • Jan Florian Heuer
  • Philip Sauter
  • Jürgen Barwing
  • Peter Herrmann
  • Thomas A. Crozier
  • Annalen Bleckmann
  • Tim Beißbarth
  • Onnen Moerer
  • Michael Quintel
Translational Research

Abstract

Background

In this study, we compare the effects of high frequency oscillatory ventilation (HFOV) with those of lung-protective volume-controlled ventilation (VCV) on cerebral perfusion, tissue oxygenation, and cardiac function with and without acute intracranial hypertension (AICH).

Methods

Eight pigs with healthy lungs were studied during VCV with low tidal volume (VT: 6 ml kg−1) at four PEEP levels (5, 10, 15, 20 cmH2O) followed by HFOV at corresponding transpulmonary pressures, first with normal ICP and then with AICH.

Systemic and pulmonary hemodynamics, cardiac function, cerebral perfusion pressure (CPP), cerebral blood flow (CBF), cerebral tissue oxygenation, and blood gases were measured after 10 min at each level. Transpulmonary pressures (TPP) were calculated at each PEEP level. The measurements were repeated with HFOV using continuous distending pressures (CDP) set at TPP plus 5 cmH2O for the corresponding PEEP level. Both measurement series were repeated after intracranial pressure (ICP) had been raised to 30–40 cmH2O with an intracranial balloon catheter.

Results

Cardiac output, stroke volume, MAP, CPP, and CBF were significantly higher during HFOV at normal ICP. Systemic and cerebral hemodynamics was significantly altered by AICH, but there were no differences attributable to the ventilatory mode.

Conclusion

HFOV is associated with less hemodynamic compromise than VCV, even when using small tidal volumes and low mean airway pressures. It does not impair cerebral perfusion or tissue oxygenation in animals with AICH, and could, therefore, be a useful ventilatory strategy to prevent lung failure in patients with traumatic brain injury.

Keywords

Volume controlled ventilation HFOV Cerebral blood flow Cerebral tissue oxygenation Hemodynamics 

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Jan Florian Heuer
    • 1
  • Philip Sauter
    • 1
  • Jürgen Barwing
    • 1
  • Peter Herrmann
    • 1
  • Thomas A. Crozier
    • 1
  • Annalen Bleckmann
    • 2
    • 3
  • Tim Beißbarth
    • 2
  • Onnen Moerer
    • 1
  • Michael Quintel
    • 1
  1. 1.Department of Anaesthesiology, Emergency- and Intensive Care MedicineUniversity of Göttingen Medical SchoolGöttingenGermany
  2. 2.Department of Medical StatisticsUniversity Medical Center GöttingenGöttingenGermany
  3. 3.Department of Hematology and OncologyUniversity Medical Center GöttingenGöttingenGermany

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